Cigarette smoking is the single most important preventable cause of morbidity, mortality, and excess health costs in the United States. Between 1995 and 1999, cigarette smoking caused 442,398 premature deaths annually and $157 billion in health-related economic losses. In 2000, 65.3% of the U.S. population completed more than 70 million clinical encounters with an oral health professional. Dental hygiene visits provide an opportunity to acquire information about the impact of tobacco use on oral health. However, significant barriers exist for providing tobacco interventions in the dental setting including lack of knowledge, time, and financial reimbursement, and a concern for poor coordination between dentistry and tobacco cessation services. Proactive telephone counseling through a tobacco quitline may provide dentists with the support they need to provide tobacco use interventions, and telephone counseling is a United States Public Health Service (USPHS) recommended format for delivering behavioral interventions. Furthermore, the dental setting provides a unique opportunity to expand tobacco use interventions to a broader population of tobacco users. In this R21 proposal, we intend to develop a novel treatment for tobacco use which capitalizes on information obtained from a dental hygiene encounter. We wish to obtain preliminary data to test the hypothesis that a brief office intervention with proactive tobacco quitline counseling incorporating patient-specific oral health information obtained during a dental hygiene visit (intervention) will increase abstinence rates from cigarette smoking compared to a brief office intervention alone (control) at 3 and 6 months. The model of the intervention will be developed using focus groups of dentists and dental hygienists as well as semi-structured interviews with dental patients who smoke cigarettes. We will pilot test the intervention by randomizing 90 cigarette smokers recruited through 8 private practice dental clinics in southeastern Minnesota to intervention or control groups. All data from this R21 will be used to develop and refine a manual of procedures (MOP) which will provide direction for a multicenter study. The overall goal of this line of research is to increase our ability to achieve the Healthy People 2010 targets of: 1) 85% of dentists counseling patients on smoking cessation; 2) 12% of the U.S. adult population smoking; and 3) 75% of smokers quitting for at least one day or longer because they are trying to quit. [unreadable] [unreadable]